Organization
ADVANCED PRACTITIONER MEDICAL GROUP - A PROFESSIONAL NURSING CORP
Active
Other names
ADVANCED PRACTITIONER MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
SHYLEE B TIAMSON FNP-C (NURSE PRACTITIONER)
(310) 292-0117
Entity
Organization
Contact information
Practice address
10570 FOOTHILL BLVD STE 210, RANCHO CUCAMONGA, CA 91730-3876
(909) 991-7577
(909) 991-7571
Mailing address
10570 FOOTHILL BLVD STE 210, RANCHO CUCAMONGA, CA 91730-3876
(909) 991-7577
(909) 991-7571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/07/2021
Last updated
04/22/2022
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